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Question:

From Melbourne, Victoria, Australia:

My teenage children (son, 14 and daughter, 16) have been diagnosed in the last 2-3 months as Type 2 diabetic. The boy is being treated with glipizide [a sulfonylurea diabetes pill usually used for Type 2 diabetes] and the girl is attempting diet control. Given no known family history of diabetes, we were wondering what explanations there may be for the children developing diabetes. Also the girl is 75 kg and 5 ft, 4 in and seems unable to lose weight no matter what she tries. Any advice would be appreciated.

Answer:

This is an unusual situation; but Melbourne is a city with major resources to help you. It is quite possible that your daughter who is clearly overweight is a Type 2 diabetic, more usually called Maturity Onset Diabetes in the Young or MODY. Treatment is often a rather disappointing affair; but it is certainly reasonable to start with a dietary approach. If your son has got the same diagnosis, it is also acceptable to start with a sulfonylurea like glipizide if he is not overweight. Just the same, it seems sensible first of all to make sure that neither of them has Type 1 Diabetes, because in that case they should both be starting on insulin even though they may be doing well enough for the time being on a diet and with glipizide. The test that will give you the answer is to look in the blood for certain antibodies that reflect the immune disorder that causes juvenile onset diabetes.

There is a third possibility which is very rare and that is that both children have an inherited disorder of the glucokinase enzyme. It occurs as a mutation in the DNA and has been called MODY-2. Nearly all of these very rare cases are shown to be autosomal dominant in their inheritance, so you would expect the problem to be present in either mother or father. There are however exceptions and to solve this possibility you would need some rather special laboratory help. Treatment for the most part is no different from other forms of diabetes.

DO'B

Original posting 17 Nov 96

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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